Standardized post-resuscitation damage assessment of two mechanical chest compression devices: a prospective randomized large animal trial

Abstract

Background Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries. Objectives To compare CPR effectiveness and thoracic injuries of two mechanical chest compression devices in pigs. Study design Prospective randomised trial. Animals Eighteen male German landrace pigs. Methods Ventricular fibrillation was induced in anaesthetised and instrumented pigs and the animals were randomised into two intervention groups. Mechanical CPR was initiated by means of LUCAS™ 2 (mCCD1) or Corpuls™ cpr (mCCD2) device. Advanced life support was applied for a maximum of 10 cycles and animals achieving ROSC were monitored for 8 h. Ventilation/perfusion measurements were performed and blood gas analyses were taken. Thoracic injuries were assessed via a standardised damage score. Results Five animals of the mCCD1 group and one animal of the mCCD2 group achieved ROSC (p = 0.048). Only the mCCD1 animals survived until the end of the monitoring period (p < 0.01). MCCD1 animals showed less pulmonary shunt (p = 0.025) and higher normal V/Q (p = 0.017) during CPR. MCCD2 animals showed significantly more severe thoracic injuries (p = 0.046). Conclusion The LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards. Trial registration Trial approval number: G16–1-042-E4.

Analysis of cerebral Interleukin-6 and tumor necrosis factor alpha patterns following different ventilation strategies during cardiac arrest in pigs

“…In our trial, we tested three different ventilatory interventions during cardiac arrest, further examining the influence of more nuanced inspiratory pressure settings on brain physiology and overall outcome post-ROSC. This continues a series of original research projects specifically targeting sophisticated novel ventilation modes and their effects on tissue inflammation, cardiac output and lung physiology ( Renz et al, 2022 ; Ruemmler et al, 2018 ; Ruemmler et al, 2021 ; Ruemmler et al, 2020 ). The chest-compression synchronized ventilation mode in particular showed promising results in previous studies regarding oxygenation and potential end-organ perfusion improvement ( Kill et al, 2015 ; Kill et al, 2009 ).…”

The Influence of Ultra-Low Tidal Volume Ventilation during Cardiopulmonary Resuscitation on Renal and Hepatic End-Organ Damage in a Porcine Model

“…On the one hand, we attributed this to fatal injuries due to mechanical resuscitation devices. These serve well to ensure standardization of chest compressions but have limitations due to the unique anatomy of pigs with their wedge-shaped sternum [ 26 , 42 ]. Moreover, we attribute the relatively low ROSC rates to the eight minute no flow time.…”

Successful transplantation of LUCAS device assisted uncontrolled DCD kidneys with prolonged relative warm ischemia time: An underutilized option in North America

“…The use of mechanical chest compression devices, such as the LUCAS device, are reported to improve organ retrieval rates from DCD donors. Mechanical chest compression devices such as the LUCAS device have been shown to maintain organ perfusion in animal models 16–18 . The mechanical pump effect of the device produces enough force to keep up the circulation of blood and therefore prevent stasis and coagulation of blood.…”

“…to maintain organ perfusion in animal models. [16][17][18] The mechanical pump effect of the device produces enough force to keep up the circulation of blood and therefore prevent stasis and coagulation of blood. Mechanical ventilation with 100% oxygenation is utilized in all situations.…”